Resectable Stage Early-Onset Biliary Tract Cancer: Survival and Prognostic Scoring (EOB-RS and EOB-OS) in Turkish Patients (TOG/GI-SAFRADJU-2502-EO).
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Akkus Erman, Kayaalp Mehmet, Ergözoğlu Müzeyyen Aslı, Koç Kuş Ilgın, Bayram Doğan, Kılıçtaş Bilgeşah, Ayvaz Güneyin Emel, Kalem Ali, Temizyürek Haydar, Çatlı Mehmet Mutlu, Akarca Mehmet Sinan, Mıldanoğlu Maral Martin, Turhan Görkem, Kara Mahmut, Arak Hacı, Arslan Tan Feyza, Paçacı Burak, Yeşilyurt Berkay, Akdoğan Orhun, Çetin Emine Bihter, Çelik Selahattin, Keskin Uzundere Fatma, Şahin Elif, Sadak Öcal Zehra, Şeker Can Lamia, Köylü Bahadır, Fidan Mehmet Cem, Kaplan Tüzün Esmanur, Şakalar Teoman, Sertesen Çamöz Elif, Yüksel Haydar Çağatay, Balçık Onur Yazdan, Peker Pınar, Yılmaz Mehmet, Ala Enli Şeymanur, Kölemen Erdem, Oyucu Orhan Sibel, Düzköprü Yakup, Ersoy Mustafa, Akın Telli Tuğba, Yılmaz Mesut, İlhan Yusuf, Yıldırım Atila, Coşar Ramazan, Ürün Müslih, Önder Arif Hakan, Araz Murat, Bayram Ertuğrul, Yeşil Çınkır Havva, Alkan Ali, Gürbüz Mustafa, Avcı Nilüfer, Paksoy Türköz Fatma, Kara İsmail Oğuz, Köse Fatih, Ünek İlkay Tuğba, Bilici Ahmet, Bal Öznur, Yalçın Şuayib, Yaşar Hatime Arzu
Аннотация
METHODS: TOG/GI-SAFRADJU (ClinicalTrials.gov identifier: NCT06975917) is a multicenter, hospital-based, registry initiative of the Turkish Oncology Group, including patients with resected BTCs. Early-onset was defined as a diagnosis at age <50 years. Characteristics and survival of EOBTC and non-EOBTC were compared. Among patients with EOBTC, prognostic factors for recurrence-free survival (RFS) and overall survival (OS) were analyzed. Risk scores were assigned on the basis of hazard ratios.
RESULTS: Six hundred seventeen patients from 44 centers were included. 12.6% (n = 78) were EOBTC. R1 resection rate was significantly higher among EOBTC (37.1% v 25.7%, P = .038). Adjuvant treatments did not differ between EOBTC and non-EOBTC. Among patients who received adjuvant chemotherapy, RFS (13.9 months [95% CI, 11.4 to 22.1] v 15.9 months [95% CI, 13.6 to 18.9], P = .947) and OS (35.6 months [95% CI, 28.0 to 81.4] v 31.3 months [95% CI, 27.8 to 44.3], P = .670) were similar between EOBTC and non-EOBTC groups. Among patients with EOBTC, R1-resection and high CA19-9 levels were associated with shorter RFS, and gallbladder localization and high CA19-9 were associated with shorter OS in adjusted analyses. Using these factors, risk scores early-stage EOBTC RFS score (EOB-RS) for RFS and early-stage EOBTC OS score (EOB-OS) for OS were formed, each including three ranks. Both scores significantly ordered the prognosis of patients with EOBTC (EOB-RS, [0 points]: 22.7 months, [1 or 2]: 10.3 months, [3]: 5.7 months, P < .001, EOB-OS: [0]: 110.9 months, [1 or 2]: 29.6 months, [3]: 10.1 months, P < .001).
CONCLUSION: Resected EOBTC patients showed survival comparable to older counterparts receiving surgery/adjuvant therapy. This study suggests a potential risk scoring system for early-stage EOBTC, pending validation.